“That’s what it shows in the logs. Somebody used the same superuser access I have to delete some data from Colchester’s record. The date stamp showed it happened postmortem. Now, why does somebody want to alter a patient record after someone has died? I didn’t think much of it, until you started talking about looking for information. Maybe someone was trying to keep a secret.”
Julie’s brow furrowed. “Can you check Sam’s file for me without anybody knowing you’re in the system?”
“Sure. I can do it from here using the superuser ID. It gives me admin access, plus I know how to mask my IP—that’s my Internet address—so I can’t be traced.”
“Do it.”
It took Jordan a few minutes to bring up White’s electronic medical records system. He used a special key that generated a one-time password. The key, the size of a credit card and nearly as thin, generated a series of numbers that cryptographically authenticated the user. It was the same technology Julie used to access the records system from any remote location, typically her home.
“Where did you get hold of one of those?” Julie asked.
Jordan was typing furiously as screens of meaningless data scrolled by at a rapid rate.
“Um, some questions I think I’d rather not answer.”
He went quiet for a bit, with the intense concentration and focus of a surgeon. Then his eyes opened wide. “Look here, you can see the date Sam’s record was created.”
Julie peered over Jordan’s shoulder at a screen titled Transaction Log. The date was the day of the accident, and it brought back dark memories.
“The transaction logs show limited data. You can see the date a record was created, and there’s a transaction type for records being added, modified, or deleted.”
“It doesn’t say what exactly was done to the record?”
“No. I’ve actually read up on that, because I had the same question. I don’t know any EMR system that records every adjustment to the medical record itself. It would create too unwieldy a file. You’d have to invest a lot of money to get a system robust enough to handle something like that. Transaction logs are used for IT troubleshooting only. Your typical techs don’t know a tibia from a femur, but they can understand transaction types just fine.”
“Did someone delete something from Sam’s record?”
“Look right here.”
Julie focused where Jordan pointed and she saw a record deletion entry made on the same day Sam had died.
“Whoever deleted the record used a superuser ID to make changes. Just like with Colchester’s EMR, I can’t tell who altered it or what they deleted.”
“Let me have a look. Maybe I can remember.”
Julie took her time to examine Sam’s extensive medical record carefully. It was all there: treatments, medications, operations, a complete compilation of an unfathomably expensive stay in the hospital. But for the life of her, Julie could not figure out what was missing from his file. Everything seemed to have been recorded properly.
Jordan came back from checking up on the girls. “What did you find?”
“I don’t see anything,” Julie admitted.
“Two cases of this rare fatal heart disease and two altered records tells me that someone isn’t going to like you digging around a bunch of EMR files on a treasure hunt. Know what I’m saying?”
“Not exactly.”
“Let me do the digging for you. I know how to get into the system and poke around without being spotted. You go in as you, and you’re broadcasting yourself to anyone who wants to keep something hidden.”’
Dr. Coffey and William Colchester were two names that popped into Julie’s head as possible secret keepers. Sherri Platt was another.
“I don’t want you involved with this, Jordan. Can you teach me how to do it?”
“Depends. How good are you with tech?”
Without embarrassment, Julie told Jordan she had needed Trevor’s help to load a music player with digital files. Jordan’s look told her plenty.
“Yeah, that isn’t going to work too well. Again, let me do it for you. I want to do it. Heck, I got this far, I should see this to the end.”
Julie thought about the man at the river and her tense meeting with William Colchester. She did not want Jordan involved, but on the flip side she wanted answers. She hesitated before extending her hand. They shook.
Partners.
* * *
LINCOLN COLE sat in his parked van, waiting for Julie to come out of Jordan Cobb’s apartment. What he needed now was some direction. He had given Julie a little shove down by the river, and then driven his motorcycle into the back of his van. He had parked right off the exit to hasten his vanishing act. He figured that after the scare, Julie would take some time off her crusade to think things over. Instead, she surprised him by paying Colchester a visit, calling Sherri Platt, and getting Jordan Cobb from White Memorial involved in her little quest.
Lincoln guessed the sizable man escorting Julie back to her car was the morgue tech. He knew Jordan Cobb by voice only. Soon he’d know everything there was to know about him. His employer needed to make some hard choices based on this new information. For now, Lincoln would do his job. He would follow the doctor. But these latest developments were very troubling. If Lincoln’s gentle shove had not done the trick, something more punishing might be in order.
Those considerations were for another time. Julie had pulled away from the curb.
And Lincoln did the same.
CHAPTER 32
Julie arrived home a little after nine o’clock and parked her Prius in her designated space. She trudged to the apartment building entrance as if she was dragging a cinder block chained to her leg. The day had drained her completely. Jordan had invited Julie to stay for dinner, but she politely declined. Best that he and the girls managed the evening routine without her interruption.
The girls were delightful, and Julie was glad to get to know the Cobb family. She was also glad Trevor was out for the night. She needed her space, quiet, and time to collect her thoughts. Julie had white wine chilled in the fridge and a new Downton Abbey on the DVR to watch. Except for Winston, the guinea pig, the apartment was hers alone for the night.
Jordan had an incredibly time-consuming task ahead of him, but he was ready to get to work. He would have to sift through all the recent deaths at White, and look at echocardiograms and EKGs for any signs of takotsubo. A third case should be something Dr. Coffey could not so easily brush aside with his Twinkie theory.
As she neared the door, a shadow cut across Julie’s vision. She stopped walking to look in that direction. An uneasy feeling took hold as a figure emerged from the darkness, a silhouette on approach. The pounding of Julie’s heart was louder than her footsteps had been. Her throat closed up, but Julie’s fear morphed into confusion when William Colchester stepped under a light. He wore a beige trench coat over his suit and Julie took special notice of his hands encased in leather gloves.
She did not like the gloves.
“What are you doing here?” Julie’s voice carried a hard edge as she squeezed her hands into fists.
“We need to talk.”
“We did that already. This is harassment. I told you as much. I’ll call the police.”
“I want to make a deal.”
“A deal?”
“That’s all. I came here with an offer.”
“How the hell do you know where I live, anyway? And how long have you been waiting for me?”
Colchester gave a sideways smile. “Long enough. And let’s just say I have a lot of loyal constituents.”
“Yeah, I know all about them. They like to share my private conversations with you and shake me down at the river. What is it you want?”
“I want you to leave this Brandon Stahl business alone.”
“And why should I do that?”
Colchester made two sidelong glances, as if worried somebody might be watching or listening. A conspiratorial look came to his face.
; “There are some legislative bills coming before the House that, if passed, are very favorable to White Memorial—taxes, zoning, matters of that nature. What’s good for White could be advantageous to you. I’d be happy to do a little lobbying if you stop trying to free my son’s killer.”
Julie’s mouth dropped open.
“Are you bribing me like the others?”
“Ugly words. I’d prefer to think of it as a mutually beneficial arrangement.”
Julie paused. Her heart continued to race from the scare, but anger also entered into the mix. “You have no business confronting me like this,” she said.
Colchester took in a ragged breath. He stepped forward. Under the harsh light, Julie could better see the pain in his eyes. Much of the color had drained from a face marred by desperation.
Without provocation, Colchester reached out with a fast hand and seized Julie by her wrist. He squeezed hard, but not so hard that it hurt. Reflexively, Julie jerked back her arm, but Colchester would not let go. He held on like a drowning man clinging to a rope.
“Brandon Stahl is a nightmare my family is trying to put behind us. I called my wife after you left my office, and told her what you said, and she’s been crying ever since. People are going to be hurt by your actions, and you’ll accomplish nothing. Please, just stop. I’m begging you to leave this alone!”
His last words came out almost as a hiss. Julie twisted her arm and ripped free of his grasp. She rubbed where he had touched her. Her eyes blazed with fury.
“Touch me again and I’ll have you arrested for assault. Show up here again and I’ll file formal harassment charges. You have no business telling me what to do.”
Colchester sank back into the shadows.
“People will be hurt by what you’re doing,” he said.
“What I’m doing is finding out the truth.”
Colchester lowered his head and dropped his shoulders in a look of defeat.
“Remember what I told you,” he said. “Just remember that.” He stuffed his hands in his coat pocket and trudged up the garage ramp to the street level.
Julie watched him go. She continued to watch even after he was out of sight. Back in her apartment, Julie almost cracked a smile as she poured herself a glass of wine. Colchester was the cap to what had been an utterly insane day. From the riverbank of western Massachusetts, to the State House, to the streets of Dorchester, the day’s events—some terrifying, some maddening, some truly baffling—played back in her mind like a disjointed dream.
After she fed Winston, Julie sank into the sofa and got three minutes into her show when her cell phone rang. She figured it might be Lucy wanting an update on her meeting with Jordan Cobb, but the caller ID came up as SHERRI PLATT.
Julie became animated. Her pulse quickened.
“Sherri, I’m so glad you called.”
Sherri made heavy breathing noises, and it sounded to Julie like she was crying.
“I want to talk,” Sherri said.
“Good. I want to know the truth.”
Sherri’s breathing remained uneven.
“I need some time … to make some arrangements first.” The young nurse was clearly distraught.
“When do you want to speak?”
“Tomorrow,” Sherri said.
“I get to work at eight,” Julie said.
“Meet me after my shift in the cafeteria. I get off at three. I’ll tell you what I know—what I did.”
“You lied in court. Didn’t you? Just tell me that?”
“Tomorrow. I’ll tell you everything.”
CHAPTER 33
Even with all that had happened in the last couple days—months, really, going back to Sam’s accident—Julie brought 100 percent of herself to the job. She could compartmentalize with the best of them. It was how she dealt with death on an almost daily basis and still managed to cook dinner for her family with a smile on her face. Sam had found this ability of Julie’s a little unsettling.
“Sociopaths can’t turn it off like you do,” Sam once remarked.
“Who said I’m not a sociopath?” Julie had answered with a wink.
She compartmentalized for Trevor and for herself, because what happened at White Memorial did not need to follow her home like some gloomy shadow.
Today, however, Julie was having a hell of a time placing her upcoming meeting with Sherri Platt into her mental lockbox where it belonged. Loads of sick and needy patients needed Julie’s attention until three o’clock rolled around. Julie also had Jordan Cobb weighing on her heavily. He should be locked up inside another of her mental compartments, but she could not help but wonder what he might find. She also regretted his involvement with this whole affair. William Colchester’s words came back to her, and hard.
People will be hurt by what you’re doing.
What people? Julie wondered. Sleep had not come easy last night, and with so many unanswered questions tumbling about her head, three o’clock could not get here fast enough.
By quarter to three, Julie had not eaten, nor had she sat down. The day had been extremely busy with the usual array of ICU happenings: respiratory disorders, a stroke, heart failure, trauma, and a case of sepsis similar to what the BC quarterback, Max Hartsock, had experienced, only without the catheter siphon.
Julie’s legs suffered the usual midday ache. Still, the ICU was stable, and another doc, Bill Goodman, came in to work, making it easier for Julie to slip away. Arriving five minutes early at the cafeteria where she and Sherri first met, Julie made a quick check of the place. Sherri was nowhere to be seen. Julie waited fifteen minutes before calling Dr. Goodman.
“Bill, it’s Julie. I was wondering how things are going up there. I’m supposed to meet someone, but they’re running late.”
“Everyone is still sick,” Dr. Goodman said. “But your presence is not immediately required, if that’s what you’re asking. You’re supposed to be off in an hour anyway. Why don’t you just call it a day? Things here are well under control.”
Julie thanked him, ended the call, and then texted Sherri Platt, but got no response. Another ten minutes went by with no sign of the nurse. Sherri had sounded anxious to meet with her. Maybe she got caught up with some work crisis on the floor. It happened all the time in the ICU. Julie called oncology and was patched through to the duty nurse.
“I’m sorry, Sherri called in sick today,” the nurse reported.
Julie cursed under her breath and used her doctor card to get Sherri’s home address.
* * *
IF JULIE had left an hour earlier, it would have taken her half the time to get to Melrose. Now she was caught in bumper-to-bumper traffic on I-93, stuck behind an eighteen-wheeler that spit exhaust like dragon’s breath. Sherri had not answered her phone or responded to any of Julie’s texts, so this whole journey might prove to be time wasted. She should be home with Trevor, who wound up having to go with Paul at the last minute. The guilt trip he had saddled her with was justified. Her kid had begged for some consistency, and here she was giving him the exact opposite.
Julie had a guess that Sherri’s sickness had something to do with a sudden change of heart. If Colchester could offer tax breaks for White Memorial, he could certainly come up with something compelling to purchase Sherri’s continued cooperation.
According to the GPS, Julie was five miles from Sherri’s Melrose home when Jordan Cobb called.
Julie spoke the command, “Answer phone,” and her hands-free Bluetooth system connected the call. Thinking of a certain white Honda Civic, Julie permitted herself to talk and drive only if her hands remained on the wheel at all times.
“Hey there,” she said, changing lanes.
“I’ve got one.”
Julie tightened her grip on the wheel. “And?”
“I started with people who had died recently, and whose death was classified in the system as a heart attack. I’m just getting rolling because there’s a lot of data to sift through, and it’s really slow going.”
/> Julie gazed out the window at the standstill traffic.
“I can relate,” she said.
“Wish I could write queries against the database, but I can’t. If I could, I might be able to pull up records for myocardial infarctions that also have a record delete transaction type in the transaction logs. That’s the pattern we’re looking for.”
“I thought you were a superuser,” Julie said.
“The superuser access is for viewing, adding, and editing records. The database stuff is with IT.”
“But you said you got one. How?”
“I was looking at names and remembered a guy I wheeled to the morgue, Tommy Grasso. He used White Memorial like a Comfort Inn. So I checked it out.”
“And?”
“And he didn’t have an echo on file, but his EKG looked a lot like our two other cases. ST-T abnormalities, QT prolongation with large negative T waves occurring in succession. So I checked the transaction log and there it was—a record of a deletion logged postmortem.”
“Any history of heart disease?”
“No. It’s the lungs that were killing him, not the heart.”
“The EKG is telling, but not telling enough. We need an echo to definitively show takotsubo type ballooning.”
“That’s gonna be tough to find.”
Julie did not disagree. Protocols for chest pain always involved an EKG. The twelve-lead setup, six on chest and four on the arms and legs, could be done in a few minutes, and computer algorithms gave interpretations immediately. Echocardiograms, by contrast, were not routine. White did not offer a twenty-four-hour echo service like some hospitals with cardiology fellowship programs staffed night and day.
“I’ll keep looking,” Jordan said. “There’s something to this, Dr. Devereux. Especially with those deleted records. It’s a pattern.”
“No, it’s a start. Look up Colchester’s file for me. Let’s compare his EKG with Tommy’s.”
“Hang on a second.”
Jordan’s second was more like a couple of minutes, in which time Julie inched her car forward maybe forty feet. She drummed her fingers restlessly on the steering wheel while waiting.
Mercy Page 21